My prognosis for doctor competency checks is more bureaucracy and more public
expense

Whenever I catch a spokesman on the radio whose salary comes out of the “public purse”, ie my wallet and yours, and who is defending a controversial decision to pay the new “Head of Talk” or “Head of BBC Trust” (or whatever it is they call the Director-General now) a high-Roman opulence of salary and perks, his reasoning is always the same.

Staggering salaries are a necessary evil at the BBC (or at Ofqual or Ofsted, or anywhere else in the public sector) because these humongously well-paid public servants would earn much, much more if they worked in the private sector. Sometimes, as the defender of the day goes on and on, defending the indefensible decision of the day, I catch myself thinking: “Ooh, I wish I worked in the private sector…”

Until I remember that I do; and always have, throughout my life, except for one short stint when I left a posh glossy for the Radio Times simply because the BBC literally doubled my salary. When I opened the letter that said “You got the job”, I fell on the floor laughing hysterically. It wasn’t a job – it was a six-month contract – but I was paid my erstwhile annual salary for the six months. And the next six! And the next! I only stayed a year and a half because I didn’t like all the low-level corruption and petty expenses-fiddling. (If you can’t add up it’s hard to fiddle expenses. Still, it makes you jolly cross when others blatantly do.)

Weirdly, Jeremy (public servant) Hunt’s attempt to explain his doctors’ (public servants) competency checks on the wireless yesterday sounded so creepily simplistic that it baffled me. “Every doctor in the country, and that includes foreign doctors who have come to practise in the UK, will have to undergo an annual appraisal,” he said, while I shouted “How much will that cost?” “and those appraisals will be reviewed every five years and then the GMC, which is the regulator of the medical profession, will decide whether there are concerns, and where there are concerns, there’s a process” – Me: “How much?” – “that doctors will go through. It’s really designed to pick up any problems before they happen.” On and on he went, about giving doctors a chance to bring their skills up to speed (presumably by retraining them at public expense? Before making them redundant, also at public expense?): “And at the end of the day, if they’re not able to do that, the end of the road would be that they’re prevented from practising.” By the GMC? Isn’t that a publicly funded body? It is. And in 2010, its “staff costs” for 605 people were £34 million. Lord, are we going to have to quintuple the annual emoluments and packages?

What concerns me is that if there is going to be revalidation of doctors, surely there will be a need for a publicly funded regulatory body – let’s call it Ofdoc – to oversee the process of revalidation and check that the annual checks on competence have been competently carried out? And the regulatory body will need someone to head it, most likely a female, because there is always pressure to feminise this overwhelmingly male Government (more power to their blokey elbow, say I). Let’s call her Cynthia – in fact, let’s call her Dame Cynthia because if not now then soon such a high honour must be due – who will be expensively procured (these things take time, especially if you’re a public-sector headhunter), and bountifully paid. I’d imagine there would be an unimaginably large (to most people) package of, say, £400,000 a year, a) because she will need to be “lured” with a fat wodge from her current job, and, b) because she could easily earn that much or scads more in the private sector. And let’s not forget that at every new layer of bureaucracy, somebody – and isn’t it most likely to be McKinsey? – will need to get their consultancy fees. I think we can agree that consultancy fees are always a given in the public sector.